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Professional Development
Annual Scientific Assembly Online Registration
Name (As you would like it to appear on badge)
First
Last
Check Applicable
MD
DO
Fellow
NP
Registrant T Shirt Size (Adult Sizes)
Small
Medium
Large
XL
2XL
3XL
AAFP Member #
Cell Phone
Email
(Required)
Clinic or Organization Name
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
While in Destin, I will be staying:
On Sandestin property, using MAFP Group Rates.
On Sandestin property, but not group rates.
Off property.
Registration Type (Before July 1)
MAFP Active Member ($525)
MAFP Life Member ($425)
Non-MAFP Member ($625)
Family Medicine Resident ($0)
Medical Student ($0)
July 1st
Guest/Spouse
Quantity
Price:
$200.00
Quantity
Guest registration is $200 for adults or children 18 and over. Includes admission to Exhibit Hall, Family Fun Night, Devotional, Yoga, Awards Luncheon, Bingo, Convention Tshirt.
Guest Names, TShirt Size (Adult S – 3XL)
Children’s Names and Ages
Bracelets will be given at regis, please wear to events
Additional Items
Sunday, July 16
MEMBER - KSA: Care of Older Adults - (1 - 5p)
Quantity
Price:
$125.00
Quantity
NON-MEMBER - KSA: Care of Older Adults - (1 - 5p)
Quantity
Price:
$250.00
Quantity
Camp MAFP Family Fun Night - (6 - 7:30p)
Quantity
Price:
$0.00
Quantity
Included with Registration
Monday, July 17
Spouse Bingo - 10a
Quantity
Price:
$0.00
Quantity
Included with Registration. Kids are welcome but will receive kids prize.
Golf Tournament at The Raven - (2p)
Quantity
Price:
$120.00
Quantity
Shotgun start
Family Crab Hunt (Evening)
Quantity
Price:
$0.00
Quantity
Included with Registration
Tuesday, July 18
MAFP Awards Lunch (Members Only) - 12:30p
Quantity
Price:
$0.00
Quantity
Included with Registration
MAFP Awards Lunch EXTRA Tickets - 12:30p
Quantity
Price:
$50.00
Quantity
MAFP Split the Pot Drawing
Quantity
Price:
$100.00
Quantity
If I win, please donate this amount to the Foundation
Enter amount you'd like donated to the foundation
Laser Tag - Included with Registration(6 - 9 pm)
Quantity
Price:
$0.00
Quantity
Included with Registration (6-7:30 for ages 14 & under, 7:30-9 for ages 15 and older)
EXTRA ITEMS: The items below will be waiting for you at the Registration Desk.
Sponsor a Student
Quantity
Price:
$50.00
Quantity
Your contribution will directly help offset the cost of medical students’ rooms & convention expenses. You will receive a Student Supporter ribbon.
Water Color Paint
Quantity
Price:
$50.00
Quantity
12 x 15 Family Medicine print, signed and numbered by artist Katie Erickson. (Special price for Annual Meeting attendees only.)
Images Book
Quantity
Price:
$50.00
Quantity
Images in MS Medicine book by family physician Dr. Luke Lampton
Extra Small (2-4)
Quantity
Price:
$20.00
Quantity
Small (6-8)
Quantity
Price:
$20.00
Quantity
Medium (10-12)
Quantity
Price:
$20.00
Quantity
Large (12-14)
Quantity
Price:
$20.00
Quantity
Adult (S)
Quantity
Price:
$20.00
Quantity
Adult (M)
Quantity
Price:
$20.00
Quantity
Adult (L)
Quantity
Price:
$20.00
Quantity
Adult (XL)
Quantity
Price:
$20.00
Quantity
Adult (2XL)
Quantity
Price:
$20.00
Quantity
Adult (3XL)
Quantity
Price:
$20.00
Quantity
Total
Credit Card
Card Details
Cardholder Name
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Home
Academy
▼
Join the MAFP
▼
Active Membership
▼
Report Your CME
Pay Dues Online
Update Current Information
Life Membership
Resident Membership
▼
Transitional Membership
Student Membership
▼
Scholarships and Awards
Mississippi Medical Schools and Residencies
Lead the MAFP
▼
Board of Directors 2023-2024
▼
Board Meeting 12.3.22
MAFP Board 10.28.22
Foundation Board Meeting 10.29.22
Board Meeting 7.15.23
MAFP Annual Meeting 7.19.23
Board Meeting 10.15.23
Board Agenda 12.2.23
MAFP Districts
MAFP Committees
▼
Committee Interest Form
Know the MAFP
▼
The Importance of Family Medicine
Vision, Mission Statement & Strategic Plan
MAFP Staff
MAFP Headquarters
MAFP Former Presidents
About Family Medicine
Advocacy
▼
Capitol Day 2024
Smith AAFP Campaign 2023
Academy Advocate
State Legislative Priorities
Legislative Report 2022
Capitol Day
Find Your Legislator
Keep the Team
Doctor of the Day
FamDocPAC
AAFP Speak Out
Mississippi CHIP Facts
Referral to Specialist Letter
Resolutions
AAFP Commissions
Workforce
▼
Spring Fling
Office of MS Physician Workforce
▼
Four Pillars for Primary Care Physician Workforce Development
Robert Graham Center
MS Rural Physicians Scholars Program
Rural Medical & Science Scholars
Academy Ambassadors
Membership & Retention Awards
Student & Resident Board Member Application
Career Link
Professional Development
▼
All about CME
ProTime
MAFP CME and Events
▼
Southeastern Family Medicine Forum
Spring Conference
Annual Scientific Assembly
▼
Annual Conference Syllabus
Fall Conference
▼
2023 Fall Conference
KSA Bootcamp 2020
Online Syllabus Login
Full CME and Event Calendar
Marketing Opportunities
▼
Exhibitors & Sponsors
Advertising
Wellness Wednesdays
Payment Models & Accountability
Degree of Fellow
Core Content Review
Your Practice
Opioid Prescribing Information
Vaccine Confidence for Doctors
Public Awareness
▼
Coronavirus
MAFP Newsletter
The Mississippi Family Physician
MAFP Directory
Press Releases
▼
Ready to See You
An Invisible Enemy
Facing a Supply Shortage with a Church’s Help
Family Medicine Residency to Open in Greenville
Dr. Robert Smith Medal of Valor
Awards
▼
Awards Nomination Form
Family Physician of the Year Award Recipients
Military Award Recipients
Humanitarian Award
New Physician of the Year Recipients
Logo Apparel
Foundation
▼
Foundation Board Agenda 7.16.23
Business Session Part 2
Donate to Foundation
Foundation Programs
▼
Lunch & Learn – Tobacco Cessation
Tobacco-Free Mississippi
Tar Wars
▼
Tar Wars Presenter Form
Foundation Fundraisers
▼
Live Healthy Tag
70 for 70 Club
Foundation Scholarships
Foundation Board of Trustees 2023-24
Foundation Partners
‘Sign on’ for the Sign